Comparison of Delayed-Onset Glaucoma and Early-Onset Glaucoma after Infantile Cataract Surgery.
- Author:
Kui Dong KANG
1
;
Hye Bin YIM
;
Albert W BIGLAN
Author Information
- Publication Type:Original Article ; Comparative Study
- Keywords: Angle closure glaucoma; Congenital cataract surgery; Delayed-onset glaucoma; Early-onset glaucoma; Open angle glaucoma
- MeSH: Time Factors; Risk Factors; Retrospective Studies; Postoperative Complications; Male; Intraocular Pressure; Infant; Humans; Gonioscopy; Glaucoma, Open-Angle/diagnosis/*etiology/physiopathology; Glaucoma, Angle-Closure/diagnosis/*etiology/physiopathology; Follow-Up Studies; Female; Child, Preschool; Child; Cataract Extraction/*adverse effects; Cataract/congenital; Age Factors; Adult; Adolescent
- From:Korean Journal of Ophthalmology 2006;20(1):41-46
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: To investigate the causes and characteristics of glaucoma in children following cataract surgery. METHODS: Twenty-four patients (37 eyes) with uncomplicated congenital cataracts who developed glaucoma after cataract surgery were studied retrospectively. Variables included cataract morphology, surgical techniques, post-operative complications, time to the onset of glaucoma, gonioscopic findings, presence of microcornea and the histopathologic characteristics of the filtration angle (in one case). RESULTS: There was a bimodal onset of glaucoma after cataract surgery. Early-onset glaucoma occurred at a mean age of 6 months in 15 eyes and delayed-onset glaucoma at a mean age of 12 years in 22 eyes. Early-onset glaucoma was significantly (p=0.018) more likely to be due to angle closure than delayed-onset glaucoma. With delayed-onset glaucoma, the filtration angle was open in 86% of eyes and significantly (p=0.006) more eyes in the delayed-onset group had microcornea. Medical treatment was sufficient to control intraocular pressure in the delayed-onset group while the early-onset group required surgical treatment (P<0.001). CONCLUSIONS: The onset of glaucoma after cataract surgery during infancy follows a bimodal pattern that is correlated with the configuration of the filtration angle. The early-onset glaucoma group had high incidence of angle closure requiring surgical treatment, while in the delayed-onset group non-surgical treatment was sufficient to control intraocular pressure. Prophylactic iridectomy in eyes at risk for pupillary block is recommended. Eyes with delayed-onset glaucoma have open filtration angles yet also have findings of incomplete development of filtration structures. Microcornea is a risk factor for delayed-onset glaucoma.
